Investigation of Endoscopic Mucosal Resection for Early Esophagel Cancer

Kentarou Maruyama, Hitoshi Shiozaki, Shigeyuki Tamura, Masatomo Inoue, Takatoshi Kadowaki, Takashi lwazawa, Kaoru Shimaya, Shigeo Matsui, Junji Gofuku, Takuya Takayama, Takesada Mori

Second Department of Surgery II, Osaka University Medical School

We have carried out endoscopic mucosal resection (EMR) for 10 patients with 12 lesions diagnosed as early esophageal squamous cell carcinomas or esophageal dysplasias by histological findings of their biopsy sections prior to surgery. In seven of the patients with eight cancer lesions, we investigated the indication for EMR of early esophageal cancer, particularly in the level of invasion. The number of lesions classified by depth of invasion was as follows: ep, 4; mm1, 2 and mm3, 2. Since one of the mm3 lesions was suspected to have invaded the lymph channels, we performed radiotherapy to the mediastinum from two weeks after EMR. While we have been following the patients for less than 33 months, we have seen no recurrence and all of the patients are alive. Presently, it is thought that early cancers, not deeper than mm2, are an absolute indication for EMR. But, it may be possible to completely treat mm3 lesions with invasion to the lymph therapy. We hope that the indication for EMR can be extended to mm3 earlv cancers.

Key words
early esophageal cancer, superficial esophageal cancer, endoscopic esophageal mucosal resection

Reprint requests
Kentarou Maruyama Second Department of Surgery II,Osaka University Medical School
2-2 Yamadaoka. Suita City, 565 JAPAN

Accepted
June 8, 1994

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